Sample declaration

Time off when your partner is pregnant


  1. I am the father of the expected child or the pregnant woman’s husband/civil partner or the pregnant woman’s live-in partner or an intended surrogate parent of the expected child.
  2. I am taking time off work in order that I may accompany the pregnant woman when she attends an appointment for the purpose of receiving ante-natal care.
  3. The appointment in question has been made on the advice of a registered medical practitioner, registered midwife or registered nurse.
  4. The date of the appointment is________________________. The time of the appointment is ________________.



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The information on the law contained on this site is provided free of charge and does not, and is not intended to, amount to legal advice to any person on a specific case or matter. If you are not a solicitor, you are advised to obtain specific legal advice about your case or matter and not to rely solely on this information. Law and guidance is changing regularly in this area.